Tens of thousands of people die each year from infections acquired in hospitals. These “hospital acquired” infections, also referred to as nosocomial infections, are unrelated to a patient's initial hospital admission diagnosis. In the United States, it has been estimated that as many as one hospital patient in ten acquires a nosocomial infection, or 2 million patients a year. Estimates of annual costs related to nosocomial infection range from $4.5 billion to $11 billion and up. Studies have shown that at least one third of nosocomial infections are preventable.
Nosocomial infections due to resistant organisms are an extremely serious problem that threatens the U.S. healthcare system and the welfare of its citizens. Microbes can acquire resistance to antibiotics and antifungal and antiviral agents and as the numbers of resistant organisms increase, the number of new antimicrobial agents to treat them has not kept pace. In fact, community acquired nosocomial infections, especially methicillin resistant staphylococcus aureus (MRSA), has increased at an alarming rate.
It is has been reported that more than 50% of all nosocomial infections can be directly related to the transmission of harmful bacteria by healthcare workers who have not properly washed their hands before and after each patient contact. Thus, the best means to prevent transfer of these organisms from patient to patient and to reduce the emergence of resistant organisms is hand washing with soap and water between patient contacts. The Centers for Disease Control and Prevention (CDC) as well as other regulatory agencies recommend hand washing before and after each patient encounter. Unfortunately, reports indicate that healthcare workers adhere to hand washing guidelines less than 70% of the time. See O'Boyle, C. A. et al., “Understanding adherence to hand hygiene recommendations: the theory of planned behavior,” Am J Infect Control., 29 (6):352-360 (2001). Numerous strategies have been attempted to increase healthcare worker compliance to hand washing, but all have been largely unsuccessful.
There are many possible reasons for non-compliance with recommended hand washing practices. For example, there may not be sufficient time to properly wash hands or wash stations may be placed in inconvenient locations. Some people simply forget to wash their hands. Others may not realize how infrequently or inadequately they comply with recommended hand washing practices. Others still may not fully understand the benefits of hand washing. Some or all of these issues may be addressed if means were provided to monitor compliance with recommended hand washing practices.
The problem of insufficient hand washing is becoming worse. Hospitals, through staff reductions, are requiring healthcare workers to attend to more patients during the healthcare provider's work shift. Additionally, high transmission rates of antibiotic resistant bacteria and viruses require greater adherence to the CDC hand washing guidelines. Hospital administrations are searching for products and services that encourage hand washing, and a means to ensure and measure compliance.
Similar concerns exist in other industries, such as those relating to the processing and preparation of food. The U.S. Food and Drug Administration's Food Code (the “Food Code”) provides guidelines for preparing food and preventing food-borne illness. Retail outlets such as restaurants and grocery stores and other institutions such as nursing homes are subject to the Food Code. In addition to requiring employees to wash their hands, the Food Code requires their employer to monitor the employees' hand washing. Despite such extensive efforts to ensure that proper hand washing is performed, more than a quarter of all food-borne illnesses (estimated that food-borne diseases cause approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths in the United States each year) are thought to be due to improper hand washing.
Numerous inventions such as touch-free, automatic soap dispensers, faucets and hand dryers attempt to address the problem of workplace hygiene by making it easier for employees to wash and sanitize their hands. For example, U.S. Pat. No. 5,945,910 teaches systems and methods in which the dispensation of cleaning agents at a washstation are monitored, where the dispensation of cleaning agents is considered an indication of a hand washing event. Another approach is taught in U.S. Pat. No. 4,896,144 which, although not designed for measuring or checking hand washing compliance, is directed to alerting someone of the need to wash their hands. U.S. Pat. No. 5,812,059 is directed to a method and system for improving hand cleanliness, primarily in a food service environment. It discloses a reporting means worn by a worker, which is activated when the worker leaves a food handling area. The reporting means, worn by the worker, is deactivated by a deactivating device associated with a hand cleaning station, and only when it is determined that the worker has used the hand cleaning station before re-entry to the food handling area.
Even with the monitoring systems described above, unless employees are actively supervised in the washroom, however, there is usually no way to determine whether they have washed their hands. Furthermore, if the employees do wash their hands, there is no way to easily determine whether they have followed a prescribed government- and/or industry-approved regimen to ensure they washed and sanitized properly.